South Florida Hospital News
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November 2008 - Volume 5 - Issue 5


The Green Card for Medical Professionals

November brings a new U.S. President; newly elected House of Representatives; and a significant number of new U.S. Senators but no expectation of a major new immigration act since reform was not a front-burner issue for either party in the 2008 campaigns. Even without new legislation, the existing law still provides a way to assist medical professionals in South Florida.

Residency in the U.S. for foreign medical professionals is of two types, temporary and permanent. This article will focus on the path to permanent residency. This goal is best achieved through obtaining an alien resident card, the "Green Card". While some attain this status because of family relationships, the speediest route for most will be an employment-based strategy.

One important group of medical professionals is foreign medical graduates (FMGs); for FMGs there is a specific set of ways to become a lawful permanent resident (green card holder). Most FMG cases involve three applications: the J-1 waiver, the H-1B and, later, an application for permanent resident status (green card).

The first step, a highly complex one, is the waiver of the two-year home country rule. FMGs are obliged to either fulfill their two-year home country requirement or obtain a waiver of that requirement as a prerequisite to obtaining an H nonimmigrant visa or permanent resident status. FMGs are eligible for waivers on three bases: (1) anticipated persecution: (2) exceptional hardship to a U.S. citizen or permanent resident spouse or child; or (3) a recommendation from an Interested Government Agency (IGA). FMGs who receive an IGA-based waiver because they will work in a medically underserved community or a VA hospital must then obtain H-1B status. They are only eligible for a green card after they have worked in H-1B status at the designated health care facility for three years.

Foreign-born nurses (RNís) already living in the U.S. can usually obtain work authorization within 5 to 6 months. To do so requires taking the RN licensing examination (officially known as the National Council Licensure Examination for Registered Nurses or the "NCLEX-RN") in any state; the employer submitting an immigrant visa petition to the appropriate United States Citizenship and Immigration Service Center on behalf of the nurse; and some additional requirements.

Individuals who are medical professionals in allied medical fields, including, but not limited to, dentists; dieticians; laboratory technicians; occupational, recreational and physical therapists; pharmacists; and psychologists can immediately start a process known as labor certification but must have a sponsoring employer. Depending on USCIS processing, a green card may be issued in 12 to 18 months.

Medical professionals can participate in the annual Diversity Visa Lottery Program, known as the Green Card Lottery, which is under way now. Under the Lottery, up to 55,000 qualified applicants will also be granted immigrant visas--Green Cards. Married individuals who win and qualify will also get visas for their spouse and eligible children. Applications for the 2010 Diversity Visa (DV-2010) Lottery will be accepted electronically until December 1, 2008.

The green card path is often confusing, complex and time consuming. Consequently, it is important that each step of the process be done correctly in order not to lose time or preclude later options.

This article is only a starting point for an individual to evaluate his or her options; nothing in it should be construed as a legal opinion or recommendation. The appropriate process is to engage a qualified attorney who can help shape an individual strategy.

Attorney Michael A. Bander, founder of Bander & Associates, P.A., an immigration and nationality law practice, can be reached at (305) 358-5800 or or visit
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